paralysis

Paralysis

Definition

Paralysis is defined as complete loss of strength in an affected limb or muscle group.

Description

The chain of nerve cells that runs from the brain through the spinal cord out to the muscle is called the motor pathway. Normal muscle function requires intact connections all along this motor pathway. Damage at any point reduces the brain's ability to control the muscle's movements. This reduced efficiency causes weakness, also called paresis. Complete loss of communication prevents any willed movement at all. This lack of control is called paralysis. Certain inherited abnormalities in muscle cause periodic paralysis, in which the weakness comes and goes.

The line between weakness and paralysis is not absolute. A condition causing weakness may progress to paralysis. On the other hand, strength may be restored to a paralyzed limb. Nerve regeneration or regrowth is one way in which strength can return to a paralyzed muscle. Paralysis almost always causes a change in muscle tone. Paralyzed muscle may be flaccid, flabby, and without appreciable tone, or it may be spastic, tight, and with abnormally high tone that increases when the muscle is moved.

Paralysis may affect an individual muscle, but it usually affects an entire body region. The distribution of weakness is an important clue to the location of the nerve damage that is causing the paralysis. Words describing the distribution of paralysis use the suffix "-plegia," from the Greek word for "stroke." The types of paralysis are classified by region:

monoplegia, affecting only one limb

diplegia, affecting the same body region on both sides of the body (both arms, for example, or both sides of the face)

hemiplegia, affecting one side of the body

paraplegia, affecting both legs and the trunk

quadriplegia, affecting all four limbs and the trunk

Causes and symptoms

Causes

The nerve damage that causes paralysis may be in the brain or spinal cord (the central nervous system) or it may be in the nerves outside the spinal cord (the peripheral nervous system). The most common causes of damage to the brain are:

Symptoms

The distribution of paralysis offers important clues to the site of nerve damage. Hemiplegia is almost always caused by brain damage on the side opposite the paralysis, often from a stroke. Paraplegia occurs after injury to the lower spinal cord, and quadriplegia occurs after damage to the upper spinal cord at the level of the shoulders or higher (the nerves controlling the arms leave the spine at that level). Diplegia usually indicates brain damage, most often from cerebral palsy. Monoplegia may be caused by isolated damage to either the central or the peripheral nervous system. Weakness or paralysis that occurs only in the arms and legs may indicate demyelinating disease. Fluctuating symptoms in different parts of the body may be caused by multiple sclerosis.

Sudden paralysis is most often caused by injury or stroke. Spreading paralysis may indicate degenerative disease, inflammatory disease such as Guillain-Barré syndrome or CIDP, metabolic disorders, or inherited demyelinating disease.

Other symptoms often accompany paralysis from any cause. These symptoms may include numbness and tingling, pain, changes in vision, difficulties with speech, or problems with balance. Spinal cord injury often causes loss of function in the bladder, bowel, and sexual organs. High spinal cord injuries may cause difficulties in breathing.

Diagnosis

Careful attention should be paid to any events in the patient's history that might reveal the cause of the paralysis. The examiner should look for incidents such as falls or other traumas, exposure to toxins, recent infections or surgery, unexplained headache, preexisting metabolic disease, and family history of weakness or other neurologic conditions. A neurologic examination tests strength, reflexes, and sensation in the affected area and normal areas.

Treatment

The only treatment for paralysis is to treat its underlying cause. The loss of function caused by long-term paralysis can be treated through a comprehensive rehabilitation program. Rehabilitation includes:

Physical therapy. The physical therapist focuses on mobility. Physical therapy helps develop strategies to compensate for paralysis by using those muscles that still have normal function, helps maintain and build any strength and control that remain in the affected muscles, and helps maintain range of motion in the affected limbs to prevent muscles from shortening (contracture) and becoming deformed. If nerve regrowth is expected, physical therapy is used to retrain affected limbs during recovery. A physical therapist also suggests adaptive equipment such as braces, canes, or wheelchairs.

Occupational therapy. The occupational therapist focuses on daily activities such as eating and bathing. Occupational therapy develops special tools and techniques that permit self-care and suggests ways to modify the home and workplace so that a patient with an impairment may live a normal life.

Other specialties. The nature of the impairment may mean that the patient needs the services of a respiratory therapist, vocational rehabilitation counselor, social worker, speech-language pathologist, nutritionist, special education teacher, recreation therapist, or clinical psychologist.

Prognosis

The likelihood of recovery from paralysis depends on what is causing it and how much damage has been done to the nervous system.

Prevention

Prevention of paralysis depends on prevention of the underlying causes. Risk of stroke can be reduced by controlling high blood pressure and cholesterol levels. Seatbelts, air bags, and helmets reduce the risk of injury from motor vehicle accidents and falls. Good prenatal care can help prevent premature birth, which is a common cause of cerebral palsy.

Resources

Books

Key terms

Computed tomography (CT) — An imaging technique in which cross-sectional x rays of the body are compiled to create a three-dimensional image of the body's internal structures.

Electromyography — A test that uses electrodes to record the electrical activity of muscle. The information gathered is used to diagnose neuromuscular disorders.

Magnetic resonance imaging (MRI) — An imaging technique that uses a large circular magnet and radio waves to generate signals from atoms in the body. These signals are used to construct images of internal structures.

Myelography — An x-ray process that uses a dye or contrast medium injected into the space around the spine.

Nerve conduction velocity test — A test that measures the time it takes a nerve impulse to travel a specific distance over the nerve after electronic stimulation.

paralysis

[pah-ral´ĭ-sis] (pl. paral´yses.)

Loss or impairment of motor function in a part due to a lesion of the neural or muscular mechanism; also, by analogy, impairment of sensory function (sensory paralysis). Paralysis is a symptom of a wide variety of physical and emotional disorders rather than a disease in itself. Called also palsy.

Types of Paralysis. Paralysis results from damage to parts of the nervous system. The kind of paralysis resulting, and the degree, depend on whether the damage is to the central nervous system or the peripheral nervous system.

If the central nervous system is damaged, paralysis frequently affects the movement of a limb as a whole, not the individual muscles. The more common forms of central paralysis are hemiplegia (in which one entire side of the body is affected, including the face, arm, and leg) and paraplegia (in which both legs and sometimes the trunk are affected). In central paralysis the tone of the muscles is increased, causing spasticity.

If the peripheral nervous system is damaged, individual muscles or groups of muscles in a particular part of the body, rather than a whole limb, are more likely to be affected. The muscles are flaccid, and there is often impairment of sensation.

Causes of Central Paralysis. stroke syndrome is one of the most common causes of central paralysis. Although there is usually some permanent disability, much can be done to rehabilitate the patient. Paralysis produced by damage to the spinal cord can be the result of direct injuries, tumors, and infectious diseases. Paralysis in children may be a result of failure of the brain to develop properly in intrauterine life or of injuries to the brain, as in the case of cerebral palsy. Congenital syphilis may also leave a child partially paralyzed. Paralysis resulting from hysteria has no organic basis and is a result of emotional disturbance or mental illness.

Causes of Peripheral Paralysis. Until the recent development of immunizing vaccines, the most frequent cause of peripheral paralysis in children was poliomyelitis. neuritis, inflammation of a nerve, can also produce paralysis. Causes can be physical, as with cold or injury; chemical, as in lead poisoning; or disease states, such as diabetes mellitus or infection. Paralysis caused by neuritis frequently disappears when the disorder causing it is corrected.

paralysis of accommodation paralysis of the ciliary muscles of the eye so as to prevent accommodation.

brachial paralysis paralysis of an upper limb from damage to the brachial plexus.

bulbar paralysis that due to changes in motor centers of the medulla oblongata; the chronic form is marked by progressive paralysis and atrophy of the lips, tongue, pharynx, and larynx, and is due to degeneration of the nerve nuclei of the floor of the fourth ventricle.

central paralysis any paralysis due to a lesion of the brain or spinal cord.

cerebral paralysis paralysis caused by an intracranial lesion; see also cerebral palsy.

Erb-Duchenne paralysis paralysis of the upper roots of the brachial plexus due to destruction of the fifth and sixth cervical roots, without involvement of the small muscles of the hand. Called also Erb's palsy.

facial paralysis weakening or paralysis of the facial nerve, as in bell's palsy.

familial periodic paralysis a hereditary disease with recurring attacks of rapidly progressive flaccid paralysis, associated with a fall in (hypokalemic type), a rise in (hyperkalemic type), or normal (normokalemic type) serum potassium levels; all three types are inherited as autosomal dominant traits.

flaccid paralysis paralysis with loss of muscle tone of the paralyzed part and absence of tendon reflexes.

Saturday night paralysis paralysis of the extensor muscles of the wrist and fingers, so called because of its frequent occurrence in alcoholics. It is most often due to prolonged compression of the radial (musculospiral) nerve, and, depending upon the site of nerve injury, is sometimes accompanied by weakness and extension of the elbow. Called also musculospiral or radial paralysis.

sensory paralysis loss of sensation resulting from a morbid process.

sleep paralysis paralysis occurring at awakening or sleep onset; it represents extension of the atonia of REM sleep into the waking state and is often seen in those suffering from narcolepsy or sleep apnea. Called also waking paralysis.

spastic paralysis paralysis with rigidity of the muscles and heightened deep muscle reflexes and tendon reflexes.

tick paralysis progressive ascending flaccid motor paralysis following the bite of certain ticks, usually Dermacentor andersoni; first seen in children and domestic animals in the northern Pacific region of North America, and now seen in other parts of the world.

pa·ral·y·sis

pa·ral·y·ses

1. Loss of power of voluntary movement in a muscle through injury or disease of it or its nerve supply.

2. Loss of any function, as sensation, secretion, or mental ability.

[G. fr. para- + lysis, a loosening]

paralysis

/pa·ral·y·sis/ (pah-ral´ĭ-sis) pl. paral´yses loss or impairment of motor function in a part due to lesion of the neural or muscular mechanism; also, by analogy, impairment of sensory function (sensory p.) .

juvenile paralysis agitans (of Hunt) increased muscle tonus with the characteristic attitude and facies of paralysis agitans, occurring in early life and due to progressive degeneration of the globus pallidus.

pseudobulbar paralysis spastic weakness of the muscles innervated by the cranial nerves, i.e., the facial muscles, pharynx, and tongue, due to bilateral lesions of the corticospinal tract, often accompanied by uncontrolled weeping or laughing.

thyrotoxic periodic paralysis recurrent episodes of generalized or local paralysis accompanied by hypokalemia, occurring in association with Graves' disease, especially after exercise or a high carbohydrate or high sodium meal.

Todd's paralysis transient hemiplegia or monoplegia after an epileptic seizure.

vasomotor paralysis cessation of vasomotor control.

paralysis

(pə-răl′ĭ-sĭs)

n.pl.paraly·ses(-sēz′)

a. Loss or impairment of the ability to move a body part, usually as a result of damage to its nerve supply.

b. Loss of sensation over a region of the body.

paralysis

[pəral′isis]pl. paralyses

Etymology: Gk, paralyein, to be palsied

the loss of muscle function, sensation, or both. It may be caused by a variety of problems, such as trauma, disease, and poisoning. Paralyses may be classified according to the cause, muscle tone, distribution, or body part affected. See also flaccid paralysis,spastic paralysis. paralytic,adj.

pa·ral·y·sis

1. Loss of power of voluntary movement in a muscle through injury to or disease of its nerve supply.

2. Loss of any function, such as sensation, secretion, or mental ability.

[G. fr. para- + lysis, a loosening]

paralysis

Temporary or permanent loss of the power of movement of a part of the body (motor function). Paralysis may be due to damage to the nerves tracts or peripheral nerves carrying motor impulses to the muscles to cause them to contract or may be due to disorders of the muscles themselves. In the former case, the damage is most commonly within the brain or the spinal cord. Paralysis of one half of the body is called HEMIPLEGIA. Paralysis of the legs and lower part of the body is called PARAPLEGIA. Paralysis of all four limbs is called QUADRIPLEGIA.

paralysis

loss of muscle function, due to damage at any level in the pathway for neural activation, or to muscle disease or relaxant drugs. See alsospinal injury.

paralysis

paralysis

Loss of action of a muscle due to injury or disease of that muscle or its nerve supply. Seepalsy.abducens paralysisSeeparalysis of the sixth nerve.paralysis of accommodationSeeparalysis of accommodation.paralysis of convergence A condition characterized by an inability of the eyes to converge while all other monocular eye movements are unaffected. The patient notices diplopia in near vision, which usually occurs suddenly. It is presumably due to some lesion in the nuclei responsible for convergence, as may happen in tabes dorsalis or Parkinson's disease.divergence paralysis A condition characterized by an inability of the eyes to diverge while all other monocular eye movements are unaffected. It is characterized by a sudden development of diplopia with marked esotropia at distance and sometimes headaches. The key difference with divergence insufficiency is the sudden onset of symptoms. Its association includes encephalitis, multiple sclerosis, head trauma, cerebral haemorrhage, brain tumour and vascular lesions of the brainstem.paralysis of the fourth nerve A condition characterized by a hypertropia of the eye with the affected superior oblique muscle. It may be due to a lesion of the fourth cranial nerve or its nucleus as a result of injury (the most common cause), vascular lesions, aneurysm or tumour. The patient usually presents with an abnormal head posture to avoid diplopia. If the condition does not recover by itself following therapy of the underlying cause, surgery is usually the only alternative treatment. Syn. trochlear paralysis. Seeabnormal head posture; trochlear nerve; paralytic strabismus.oculomotor paralysisSeeparalysis of the third nerve.paralysis of the sixth nerve A condition characterized by an esotropia of the eye with the affected lateral rectus muscle. It may be due to a lesion of the sixth cranial nerve or its nucleus as a result of a vascular disease (e.g. diabetes, hypertension), injury, or tumour. The patient presents with an abnormal head turn to avoid diplopia. If the condition does not recover by itself following therapy of the underlying cause, surgery is usually the only alternative treatment. Syn. abducens paralysis; lateral rectus palsy. Seeabnormal head posture; abducens nerve; paralytic strabismus; Gradenigo's syndrome; transposition.paralysis of the third nerve A condition that leads to a wide impairment of motor function, as this nerve innervates most of the muscles of the eye. It may be due to a vascular disease (e.g. diabetes, hypertension), aneurysm (especially of the internal carotid artery), injury or tumour. In total paralysis only the lateral rectus and the superior oblique muscles will be spared and the eye will be in a position of abduction, slight depression and intorsion. Ptosis will also be present and the pupil will be dilated and non-reactive, and there will also be paralysis of accommodation. If the condition does not recover by itself following therapy of the underlying cause, surgery is usually the only alternative. Syn. oculomotor paralysis. Seecircle of Willis; oculomotor nerve; ophthalmoplegia; paralytic strabismus; Benedikt's syndrome; Weber's syndrome; forced duction test; transposition.trochlear paralysisSeeparalysis of the fourth nerve.

pa·ral·y·sis

, pl. paralyses (păr-al'i-sis, -sēz)

1. Loss of power of voluntary movement in a muscle through injury or disease of it or its nerve supply.

2. Loss of any function.

[G. fr. para- + lysis, a loosening]

paralysis (pəral´isis),

n1. the cessation of cell function. n2. the loss or impairment of the motor control or function of a part or region.

paralysis, diplegia

n a loss of motor function in matching body parts (e.g., legs) on each side.

paralysis, facial,

n paralysis of the muscles of facial expression resulting from supranuclear, nuclear, or peripheral nerve disease. With a mild case, when the face is at rest, the disorder is not readily observed. However, during muscular contraction (e.g., wrinkling the forehead, blinking the eyes, pursing the lips, speaking), the disorder is very noticeable. Only one lid may close, and the asymmetry of the oral cavity is pronounced because the normal buccinator muscle contracts and is unopposed by the weakness on the paralyzed side. This imbalance produces a significant asymmetry. The affected side remains smooth, and the normal side shows contraction. See also palsy, Bell's.

n a loss of the power of skeletal muscle contraction, resulting from interruption of some part of the pathway from the cerebrum to the muscle.

paralysis, transient,

n the sudden loss of sensation or ability to move on one side or a single part of the body, which lasts briefly and may or may not recur and is often a symptom of cerebrovascular insufficiency or other underlying serious condition.

paralysis, transient facial,

n a temporary unilateral loss of facial muscle function as a result of inadvertently injecting the parotid gland containing the facial nerve during the inferior nerve block.

paralysis

loss or impairment of motor function in a part due to a lesion of the neural or muscular mechanism; also, by analogy, impairment of sensory function (sensory paralysis). Called also palsy. Motor paralysis may be expressed as flaccid, in the case of lower motor neuron lesion, or spastic, in the case of an upper motor neuron lesion. See also paraplegia, quadriplegia, hemiplegia and paralyses of individual cranial and peripheral nerves.

paralysis of accommodation

paralysis of the ciliary muscles of the eye so as to prevent accommodation.

anal paralysis

manifested by flaccidity and lack of tone of the anal sphincter, and loss of house training restraint in companion animals.

antepartum paralysis

pressure on sciatic nerves by a large fetus in late pregnancy in a cow can cause posterior paralysis that is cured by a cesarean section.

ascending paralysis

spinal paralysis that progresses forwards involving first the hindlimbs then the forelimbs, then the intercostal muscles, then the diaphragm, and finally the muscles of the neck.

birth paralysis

that due to injury received by the neonate at birth.

bladder paralysis

manifested by fullness of the bladder and response to manual pressure. See also motor paralytic urinary bladder.

cage paralysis

see thiamin nutritional deficiency.

central paralysis

any paralysis due to a lesion of the brain or spinal cord.

cerebral paralysis

paralysis caused by some intracranial lesion.

Chastek paralysis

see thiamin nutritional deficiency.

compression paralysis

that caused by pressure on a nerve.

congenital paralysis

paralysis of the newborn. Many cases are due to birth trauma especially when lay persons exert excessive traction. Other causes are enzootic ataxia, inherited congenital paraplegias in calves and pigs, spina bifida and spinal dysraphism and occipito-alanto-axial malformations in foals and puppies.

Patient discussion about paralysis

Q. What Is Bell's Palsy? A friend of mine has been told she has Bell's palsy. What happens in this disease?

A. Bell's palsy is defined as an idiopathic (from an unknown reason) unilateral facial nerve paralysis, usually self-limiting. The trademark is rapid onset of partial or complete palsy, usually in a single day.Here you can learn more about what exactly is Bell's palsy- http://www.5min.com/Video/What-is-Bells-Palsy-5500

Q. What are the causes of bell's palsy?

A. I had it 5 years ago at age 20. All the symptoms of the above are correct not to mention the tiredness and rapid blinking of the eye from the effected side.

In my case I have just found out that I have a non milignate tumor behind my left eye which was likely to be the cause of the Bell Pausy in the first place. I encourage anyone who has symptoms or pain spanning more than 8 weeks to see their doctor and if possible request request or demand a MRI scan for peace of mind.

If pain persists get a second opinion and dont let the Dr. shrugg you off.

Q. I go to sleep & use to wake up paralyzed in my sleep. I go to sleep & use to wake up paralyzed in my sleep. But not asleep, just laying there, eyes wide open paralyzed. I couldn't breath, I couldn't speak, move anything but my eyes. I could look around but I couldn't even breathe. This has happened a few times in my old house, once in my mother's house (she lived by the side of a graveyard), and then only once in my new house. What is it and what do you think is causing it?

A. I had the same problem but never at night...and it only happened during the day when I take nap. I will wake up and I can't move or talk, I can't open my eyes either. I've never been able to snap out of it though, I just have to lay there until I go back to sleep, and usually it doesn't happen when I wake up the next time. Needless to say I try NOT to take naps anymore, because it happens nearly every time.

All content on this website, including dictionary, thesaurus, literature, geography, and other reference data is for informational purposes only. This information should not be considered complete, up to date, and is not intended to be used in place of a visit, consultation, or advice of a legal, medical, or any other professional.